C10019430 / invoice 10000

History:- Sticky bum for a few months, constipation with straining during defecation.- Inconsistent anal gland issues for two months, with a significant odour noted.://- Bumps around eyes that resolve within a day.- Hair loss on chest.- Consistent ear infections, managed with ear wash.- Paw biting, particularly with certain grasses.- Diet: Taste of the Wild, half a scoop daily. Also receives chicken from the deli or boiled chicken and carrots.Past Medical History:- Previous episodes of anal gland issues, not consistent.- History of paw biting and grass sensitivity.Physical Examination:- Demeanour: Good.- Skin: Hair thinning on the chest, suspected friction-related alopecia. No pustules or papules. A cyst was noted.- Ears: No significant findings on external examination.- Anal Glands: Moderately full, easily expressed. No signs of infection.Investigations/Laboratory:- Ear cytology (both ears): Negative for infectious organisms. Debris and wax present.Assessment & Plan:1. Anal Gland Issues- Impression: Anal gland impaction.- Treatment planned: Anal glands expressed. Owner demonstrated how to express glands at home.- Clinician's recommendations, education and counselling: Discussed Glanex as a potential supplement. Advised that fibre may not resolve the gland issue but is important for stool quality. Recommended recheck in 6 weeks if symptoms persist.2. Constipation & Diet- Impression: Low-fibre diet contributing to constipation.- Clinician's recommendations, education and counselling: Advised to increase dietary fibre. Recommended pumpkin and sweet potato. Discussed that current diet (Taste of the Wild) is low in fibre.3. Skin Issues (Bumps, Hair Loss, Paw Biting)- Impression: Likely allergic reaction or friction alopecia.- Clinician's recommendations, education and counselling: Advised that bumps around eyes are likely an allergic reaction and should resolve. Hair loss on chest is likely friction from rubbing on the ground. Paw biting is likely related to grass sensitivity. No specific treatment recommended at this stage.4. Ear Infections- Impression: No active infection.- Clinician's recommendations, education and counselling: Ear cytology was negative. Continue with current ear wash regimen. No further treatment required.Key Takeaways:- Increase dietary fibre with pumpkin or sweet potato.- Monitor anal gland odour and function.- Continue ear cleaning as per current routine.Next Steps:- Recheck anal glands in 6 weeks if odour or discomfort persists.- Call if any concerns arise. No formal recheck appointment needed unless issues develop.

Reason: VaccHistory: EDFU okNO V+ or D+Examine: HR =124mm=pink CRT<2chest NADabdo NADears eyes NADteeth NADT=Nall other NADAssessment: NSF on PEfit for vaccPlan: nobivac 3yr C4oral BBnobivac lepto (booster 2-4 weeks)on simparica trio

History:- Suspected ear infection in one ear. Owner cleaned the ear with saline eye wipes with no improvement.- Appetite, thirst, urination, and defecation are all normal.- Not on any current medications - The owner noticed some discharge, but is not bothered by it. No head shaking or rubbing. Mood and activity levels (walks, playing) are unchanged.- Swims regularly but not recently.Past Medical History:- Known allergy to a certain type of grass, which is avoided. No other history of skin issues or allergies.- No previous ear infections.Physical Examination:- Demeanour: Anxious but cooperative for examination.- R ear- Otoscopic examination: Ear canals appear clear. Some discharge noted on the surface of the pinna, but not deep in the canal.- Ear swab taken for cytology.Investigations/Laboratory:- Ear cytology: No evidence of yeast or bacteria.Assessment & Plan:1. Suspected Otitis Externa- Impression: Mild superficial irritation.- Investigations planned: None.- Advised this may be the start of an infection or an overgrowth of normal flora due to an irritant. As cytology is clear and there are no clinical signs of discomfort, medicated treatment is not required at this stage. Recommended cleaning the ear daily for 3-4 days to see if it resolves.- Treatment planned: Dispensed Oto flush ear cleaner. Instructed owner on cleaning technique: apply into the canal, massage the base, and wipe away excess.Key Takeaways:- Clean the affected ear daily for 3-4 days with Otiplast.- Monitor for signs of worsening irritation, such as redness, increased discharge, head shaking, or scratching.Next Steps:- Recheck if the ear does not improve or if symptoms worsen.- Consider cooperative care training to reduce anxiety with handling.